A study of functional and radiological outcome in JIA: In a tertiary care teaching Medical College hospital.

Balameena Selvakumar; Aravindan Ambigapathy

Volume : VII, Issue : X, October - 2018

A study of functional and radiological outcome in JIA: In a tertiary care teaching Medical College hospital.

Balameena Selvakumar, Aravindan Ambigapathy

Abstract :

Introduction: Juvenile idiopathic arthritis (JIA) is a chronic debilitating disease¹.The outcome of the disease has much changed since the introduction of newer therapies.

Aim: To find out the clinical profile, functional outcome and the radiological score in a cohort of JIA patients.

Materials and Methods: This study included 30 children with JIA attending Institute of Rheumatology (IOR), Madras Medical College, who fulfilled the classification criteria for JIA as per ILAR and with significant wrist involvement.²The study period was January 2012 to December 2013. History, clinical examination, musculoskeletal examination, laboratory investigations, outcome indices (including CHAQ) and radiological indices (Poznanski�s score) were done for all patients. The study was done after Institutional Ethical committee approval and informed consent from patients and parents.

Results: The mean age of the patients in Oligoarticular was 5.17�2.34, in polyarticular 8.01�3.04 and in systemic JIA was 6.3�2.301. In this cohort, 14 had Oligoarticular type, 10 had polyarticular type and 6 had systemic JIA type. Boys were 14 in number and 16 were girls. The worse Pozanski score was seen in 14.28% of Oligoarticular type, 30% in polyarticular type and 33.33% in systemic JIA type. CHAQ improved during the study period in majority of domains of Oligoarticular type ( p value of 0.6) and in polyarticular type( p value was 0.03). In systemic JIA type, the p value for CHAQ was 0.133. There was also improvement in the acute phase reactants and functional outcome.

Conclusion: The outcome of JIA is dependent on early diagnosis, appropriate therapy and duration of therapy.Oligoarticular type has the best overall prognosis and good functional outcome. Children with systemic JIA have the most severe disease and had poor functional outcome. Nearly 33.3% of systemic JIA had worse Pozanski score.This study shows that CHAQ reflects the severity of disease and the prognosis of JIA depends on the type of JIA functional outcome of the patients correlates with acute phase reactants in polyarticular and systemic onset J I A Radiological score can be an useful tool for assessing the prognosis of the patients but larger cohort and longer duration would add more to our knowledge in this aspect.